Effects and Safety of Laparoscopic Cholecystectomy and Open Cholecystectomy for Chronic Atrophic Cholecystitis:A Meta-Analysis of RCTs_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HEXue-wen ¹ , WANGWen-hui ¹ ,  CHAIChen ²

1. Department of Interventional Radiology Combined with Traditional Chinese and Western Medicine, The First Affiliated Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China;
2. DepartmentⅠ of General Surgery, The First Affiliated Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China;

Corresponding?author：

HEXue-wen, Email: hxw112082@hotmail.com; CHAIChen, Email: chasechai@126.com

Keywords：

Chronic atrophic cholecystitis; Laparoscope; Laparotomy; Meta-analysis

DOI：

10.7507/1007-9424.20140202

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically evaluation the efficacy and safety of laparoscopic cholecystectomy(LC) and open cholecystectomy(OC) for chronic atrophic cholecystitis. Methods Standard electronic database such as PubMed, Web of science, Cochrane library, CNKI, VIP, CBM, and Wanfang database were searched to retrieve relevant randomized controlled trials(RCTs) that comparing LC with OC, which were analyzed systematically using RevMan5.2. Results Seven RCTs including 758 patients were brought into this Meta analysis. There were significant differences between two groups regarding operative time(MD=-27.70, 95% CI:-44.25--11.16, P=0.001), amount of blood loss during operation(MD=-113.25, 95% CI:-141.68--84.81, P < 0.000 01), the recovery time of gastrointestinal function(MD=-28.49, 95% CI:-29.80--27.18, P < 0.000 01), and length of hospital stay(MD=-3.83, 95% CI:-6.01--1.65, P=0.000 6), There were statistically significant difference in utilization rate of anodynes after operation(MD=0.12, 95% CI:0.06-0.23, P < 0.000 1) and terrible postoperative complications(MD=0.24, 95% CI:0.12-0.47, P < 0.000 01) between LC and OC. Conclusions In both efficacy and safety, LC for chronic atrophic cholecystitis are significantly superior than the traditional OC. But now the clinical randomized controlled trials about LC is less and the quality is poor, so that its long-term safety evaluation still needs large sample quality RCTs to be further verified.

Citation： HEXue-wen, WANGWen-hui, CHAIChen. Effects and Safety of Laparoscopic Cholecystectomy and Open Cholecystectomy for Chronic Atrophic Cholecystitis:A Meta-Analysis of RCTs. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(7): 855-861. doi: 10.7507/1007-9424.20140202 Copy

1.	?周錢江, 王躍東, 竺楊文, 等.慢性萎縮性膽囊炎腹腔鏡切除術95例臨床分析[J].肝膽胰外科雜志, 2008, 20(4):288-289.
2.	陳廣泰.腹腔鏡膽囊切除術治療慢性萎縮性膽囊炎臨床分析[J].中外醫療, 2010, 29(32):92.
3.	廉世松, 楊吉田, 彭玲霞.沅陵縣農村居民膽囊結石的調查分析[J].中國民康醫學, 2011, 23(3):336-337.
4.	譚宜將, 劉衍民.膽囊結石發病原因研究現狀與進展[J].中國實用外科雜志, 2009, 29(7):602-603, 606.
5.	史建中, 萬煥真.腹腔鏡膽囊切除術在老年急性膽囊炎患者中的應用探討[J].中國普通外科雜志, 2011, 20(8):895-897.
6.	胡三元.腹腔鏡臨床診治技術[M].濟南:山東科學技術出版社, 2002:77.
7.	Giger U, Michel JM, Vonlanthen R, et al. Laparoscopic cholecystectomy in acute cholecystitis:indication, technique, risk and outcome[J]. Langenbecks Arch Surg, 2005, 390(5):373-380.
8.	王和曹, 余鵬.腹腔鏡膽囊切除術治療急性膽囊炎46例分析[J].肝膽胰外科雜志, 2009, 21(1):74-75.
9.	Higgins JPT GSe. Cochrane Handbook for Systematic Reviews of Interventions Version 5. 1. 0[DB/OL]. Available from http://www.cochrane.org/handbook.
10.	Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J]. Control Clin Trials, 1996, 17(1):1-12.
11.	余輝.腹腔鏡膽囊切除術對慢性萎縮性膽囊炎的療效分析[J].中國民族民間醫藥, 2012, 21(24):79.
12.	賈丹.腹腔鏡手術治療慢性萎縮性膽囊炎80例的效果分析[J].中國醫學創新, 2013, 10(24):117-118.
13.	張縣強.腹腔鏡手術治療慢性萎縮性膽囊炎的臨床效果分析[J].中國醫藥科學, 2012, 2(8):166-167.
14.	吳偉, 余育暉.腹腔鏡與傳統開腹手術治療慢性萎縮性膽囊炎的臨床療效對照研究[J].中國普通外科雜志, 2013, 22(8): 1090-1092.
15.	薛應祥, 黃健.腹腔鏡與開腹膽囊摘除術的效果比較[J].西部醫學, 2011, 23(3):509-510.
16.	張坤, 所廣軍, 陳銅兵.腹腔鏡與開腹手術治療慢性萎縮性膽囊炎的療效比較[J].北方藥學, 2012, 9(12):51.
17.	王昌松, 羅洪, 趙少勇.腹腔鏡與開腹手術治療慢性萎縮性膽囊炎的臨床療效比較[J].航空航天醫藥, 2010, 21(7):1143-1144.
18.	何振興, 馬海, 楊紅春, 等.年輕醫師腹腔鏡膽囊切除術的學習曲線探討[J].中國普外基礎與臨床雜志, 2013, 20(11): 1284-1286.
19.	夏永紅.腹腔鏡膽囊切除術和開腹膽囊切除術后并發癥發生率的比較[J].中國普通外科雜志, 2012, 21(8):1010-1012.
20.	葛長青, 李全福, 劉建輝, 等.腹腔鏡輔助膽道鏡保膽取石術與腹腔鏡膽囊切除術的比較[J].中國內鏡雜志, 2012, 18(2): 199-202.
21.	盧茂松, 劉強, 黃征燾.電視腹腔鏡膽囊切除術及小切口開腹膽囊切除術的臨床比較[J].現代預防醫學, 2011, 38(2): 380-381.
22.	梁治升, 崔清楓, 勾承月.慢性萎縮性膽囊炎的腹腔鏡治療[J].中國醫藥導報, 2009, 6(16):55-56.
23.	吳碧勝, 向建軍.腹腔鏡和傳統開腹膽囊切除術對患者腸道黏膜通透性影響的比較[J].中國普通外科雜志, 2013, 22(4): 532-535.
24.	汪衛平.腹腔鏡與開腹手術治療慢性萎縮性膽囊炎的臨床療效比較[J].中外醫學研究, 2011, 9(26):34-35.
25.	梁治升, 崔清楓, 勾承月.腹腔鏡與開腹手術治療慢性萎縮性膽囊炎的臨床療效比較[J].中國醫藥導報, 2009, 6(32):22-23.
26.	張志強, 張楠, 馬杰, 等.萎縮性膽囊炎手術方式探討[J].基層醫學論壇, 2012, 16(7):950-951.

1. ?周錢江, 王躍東, 竺楊文, 等.慢性萎縮性膽囊炎腹腔鏡切除術95例臨床分析[J].肝膽胰外科雜志, 2008, 20(4):288-289.
2. 陳廣泰.腹腔鏡膽囊切除術治療慢性萎縮性膽囊炎臨床分析[J].中外醫療, 2010, 29(32):92.
3. 廉世松, 楊吉田, 彭玲霞.沅陵縣農村居民膽囊結石的調查分析[J].中國民康醫學, 2011, 23(3):336-337.
4. 譚宜將, 劉衍民.膽囊結石發病原因研究現狀與進展[J].中國實用外科雜志, 2009, 29(7):602-603, 606.
5. 史建中, 萬煥真.腹腔鏡膽囊切除術在老年急性膽囊炎患者中的應用探討[J].中國普通外科雜志, 2011, 20(8):895-897.
6. 胡三元.腹腔鏡臨床診治技術[M].濟南:山東科學技術出版社, 2002:77.
7. Giger U, Michel JM, Vonlanthen R, et al. Laparoscopic cholecystectomy in acute cholecystitis:indication, technique, risk and outcome[J]. Langenbecks Arch Surg, 2005, 390(5):373-380.
8. 王和曹, 余鵬.腹腔鏡膽囊切除術治療急性膽囊炎46例分析[J].肝膽胰外科雜志, 2009, 21(1):74-75.
9. Higgins JPT GSe. Cochrane Handbook for Systematic Reviews of Interventions Version 5. 1. 0[DB/OL]. Available from http://www.cochrane.org/handbook.
10. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J]. Control Clin Trials, 1996, 17(1):1-12.
11. 余輝.腹腔鏡膽囊切除術對慢性萎縮性膽囊炎的療效分析[J].中國民族民間醫藥, 2012, 21(24):79.
12. 賈丹.腹腔鏡手術治療慢性萎縮性膽囊炎80例的效果分析[J].中國醫學創新, 2013, 10(24):117-118.
13. 張縣強.腹腔鏡手術治療慢性萎縮性膽囊炎的臨床效果分析[J].中國醫藥科學, 2012, 2(8):166-167.
14. 吳偉, 余育暉.腹腔鏡與傳統開腹手術治療慢性萎縮性膽囊炎的臨床療效對照研究[J].中國普通外科雜志, 2013, 22(8): 1090-1092.
15. 薛應祥, 黃健.腹腔鏡與開腹膽囊摘除術的效果比較[J].西部醫學, 2011, 23(3):509-510.
16. 張坤, 所廣軍, 陳銅兵.腹腔鏡與開腹手術治療慢性萎縮性膽囊炎的療效比較[J].北方藥學, 2012, 9(12):51.
17. 王昌松, 羅洪, 趙少勇.腹腔鏡與開腹手術治療慢性萎縮性膽囊炎的臨床療效比較[J].航空航天醫藥, 2010, 21(7):1143-1144.
18. 何振興, 馬海, 楊紅春, 等.年輕醫師腹腔鏡膽囊切除術的學習曲線探討[J].中國普外基礎與臨床雜志, 2013, 20(11): 1284-1286.
19. 夏永紅.腹腔鏡膽囊切除術和開腹膽囊切除術后并發癥發生率的比較[J].中國普通外科雜志, 2012, 21(8):1010-1012.
20. 葛長青, 李全福, 劉建輝, 等.腹腔鏡輔助膽道鏡保膽取石術與腹腔鏡膽囊切除術的比較[J].中國內鏡雜志, 2012, 18(2): 199-202.
21. 盧茂松, 劉強, 黃征燾.電視腹腔鏡膽囊切除術及小切口開腹膽囊切除術的臨床比較[J].現代預防醫學, 2011, 38(2): 380-381.
22. 梁治升, 崔清楓, 勾承月.慢性萎縮性膽囊炎的腹腔鏡治療[J].中國醫藥導報, 2009, 6(16):55-56.
23. 吳碧勝, 向建軍.腹腔鏡和傳統開腹膽囊切除術對患者腸道黏膜通透性影響的比較[J].中國普通外科雜志, 2013, 22(4): 532-535.
24. 汪衛平.腹腔鏡與開腹手術治療慢性萎縮性膽囊炎的臨床療效比較[J].中外醫學研究, 2011, 9(26):34-35.
25. 梁治升, 崔清楓, 勾承月.腹腔鏡與開腹手術治療慢性萎縮性膽囊炎的臨床療效比較[J].中國醫藥導報, 2009, 6(32):22-23.
26. 張志強, 張楠, 馬杰, 等.萎縮性膽囊炎手術方式探討[J].基層醫學論壇, 2012, 16(7):950-951.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effects and Safety of Laparoscopic Cholecystectomy and Open Cholecystectomy for Chronic Atrophic Cholecystitis:A Meta-Analysis of RCTs

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